Fixed Drug Eruption

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CLINICAL DESCRIPTION

An adverse cutaneous drug reaction that recurs at the same site with repeated exposure to the same agent though new areas may be involved in subsequent attacks.

CLINICAL FEATURES

SIGNS AND SYMPTOMS

• Itching and/or pain on affected area
• Typically, round sharply demarcated red-brown patch or plaque
• Occasionally may be bullous
• Later becomes darker
• Lesions can be found anywhere on the body but favours the lips, face, hands, feet and genitalia

INVESTIGATIONS

• Clinical and in relation to history

Drugs most frequently associated with FDE

• Sulphonamides
• NSAIDS
• Tetracyclines
• Barbiturates
• Carbamazepine
• Stop the offending medicine

TREATMENT

• Avoid triggering agent
• Use potent topical steroids e.g., Betamethasone 0.05% cream 12 hourly

If severe:

• Give Chlorpheniramine 4-8mg PO 12 hourly for 7 -14 days